In Vivo Analysis of Hindfoot Joints Movement During Stance Phase in Stage Ⅱ Adult Acquired Flatfoot Deformity

Background This study aims to compare the kinematic characteristics of hindfoot joints of stage Ⅱ adult acquired flatfoot deformity (AAFD) and normal foot through two-dimension (2D) -three-dimension (3D) registration technology and a single fluoroscopic imaging system, thus to provide research basis to the pathogenesis, diagnosis and treatment of AAFD. Methods Then seven normal volunteers and eight volunteers with stage Ⅱ AAFD were recruited to take the CT scans for their bilateral feet in neutral positions, after that their lateral dynamic X-ray data during stance phase were collected including fourteen normal feet and ten flatfeet. A computer-aided simulated light source for 3D CT model was applied to obtain a virtual image, and it is matched with the dynamic X-ray images to make a registration in “Fluo” software, by which finally the spatial changes during the stance phase can be calculated. Results In the early stage of touching the ground and the middle stage of standing, the extension and external rotation valgus of the navicular bone of the flat foot was compared with that of the normal navicular bone, and there was no significant difference in the extension and external rotation valgus of the calcaneus between the cuboid phase and the normal navicular bone. In the late stance phase, the degree of varus relative to the distance of the navicular bone was smaller in the flat foot than in the normal foot but the degree of metatarsal flexion was not significantly different between the cuboid and the calcaneus, and the degree of varus was smaller in the calcaneus but the degree of metatarsal flexion was greater. Conclusion During the early and mid-stance phase, there are excessive motion in the subtalar and talonavicular joints in stage Ⅱ AAFD. During the late stance phase, the motion of subtalar and talonavicular joints are in the decompensated state. During the whole stance phase, the motion of calcaneocuboid joint has no significant difference in both normal foot and stage Ⅱ AAFD.

COMPUTED TOMOGRAPHY MEDICAL IMAGE ANALYSIS OF BASKETBALL PLAYERS’ BONE GEOMETRY

ABSTRACT Introduction: Basketball sports will effect on the morphology and structure of the hand bones and joints. Objective: The article selected nine professional basketball players (basketball group) and 11 non-basketball players (control group) in the provincial youth team. A 64-row spiral computed tomography scan was used to scan the wrist and three-dimensional reconstruction. The volume of each carpal bone and the computed tomography value (bone density) were measured. Methods: To explore the influence of basketball sports on the hand bones and joints’ morphological structure, the paper analyzes the structural characteristics of the computed tomography images of young male basketball players’ wrist bones. Results: Compared with the carpal bones in the control group, the volume of the right navicular bone and the small polygonal bone, the left-hand navicular bone, the large triangular bone, and the small polygonal bone in the basketball group increased significantly (P<0.05). Conclusions: Basketball can increase the volume of the part of the wrist bones of adolescent male athletes and reduce the bone density; the morphological structure of the non-smashing wrist bones of basketball players has similar changes to that of the spikers. Level of evidence II; Therapeutic studies - investigation of treatment results.

The Effects of a Medial Heel Wedge on the Weight-Bearing Response of Hindfoot Valgus and the Total Weight-Bearing Responses of the Navicular and Talus Bones

OBJECTIVES Medial heel wedges are commonly prescribed to manage the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones. Previous studies have reported that a medial heel wedge is effective in the management of musculoskeletal injuries. However, it remains unclear the effect of a medial heel wedge on the weight-bearing responses of footarch bones in vivo. To clarify the effects of a medial heel wedge on the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones is necessary to understand how best to treat musculoskeletal injuries clinically. The purpose of our study was to clarify the effects of a medial heel wedge on the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones.METHODS Twenty-five healthy males were analyzed. We obtained MRI scanning of the right foot under non-loading (NL) and full weight-bearing (FW) conditions. Participants wore two insole types, a flat insole and a medial heel wedge. To evaluate the weight-bearing response in hindfoot valgus, the hindfoot alignment view (HAV) was measured. We also measured navicular and talus bone positions and calculated the total positional changes of the navicular and talus bones (ΔTPCN, ΔTPCT) from the vertical and medial displacements using the Pythagorean theorem.RESULTS Significant interactions were observed with the HAV. Under both NL and FW conditions, the HAV was smaller on the medial heel wedge than on the flat insole. In addition, the ΔTPCN was significantly smaller on the medial heel wedge than on the flat insole. However, no significant differences were observed for ΔTPCT.CONCLUSIONS Our results suggest that use of a medial heel wedge decreases hindfoot valgus values under both NL and FW conditions and stabilizes the total weight-bearing response of the navicular bone.

Comparison Between Ultrasonographic and Standing Magnetic Resonance Imaging Findings in the Podotrochlear Apparatus of Horses With Foot Pain

This prospective study aimed to blindly compare the ultrasonographic and standing magnetic resonance imaging (sMRI) findings in deep digital flexor tendon (DDFT), navicular bone, and navicular bursa in horses with foot pain, positive digital analgesia, and without definitive radiographic diagnosis. Ultrasonography detected more DDFT abnormalities (32/34 feet vs. 27/34 with sMRI) but identified less palmar navicular abnormalities (23/34 feet vs. 30/34 with sMRI). In suprasesamoidean DDFT lesions, which were mainly dorsally located, changes in echogenicity did not correspond to a particular pattern of sMRI signal change. Transcuneal ultrasonography did not allow assessment of morphology and extent of distal DDFT lesions, and sporadically discriminated the affected lobe compared to sMRI. Defects of the palmar compact bone were identified with both modalities except a parasagittal defect, which was only seen at sMRI.

Relationship Between the of Type of Accessory Navicular Bone and Radiological Parameters of the Foot

BACKGROUND:In this study, we evaluated to the relationship between the type of accessory navicular bone (ANB) and radiological parameters of foot in patients with bilateral ANB of different types. METHODS:Patients with bilateral ANB of different types participated in this study, from May 2019 to April 2020. Patient data, including age, sex, body mass index (BMI), and presence of symptoms were obtained. We aimed to compare the radiological parameters of both the feet for evaluate the differences from one another in patients with bilateral ANB of different types (one side type 1 and contralateral side type 2) because the foot angles may differ in each person. Seven radiographic parameters were measured, including calcaneal pitch angle, talocalcaneal angle, tibiocalcaneal angle, naviculocuboid overlap, talonavicular coverage angle, anteroposterior talo-first metatarsal angle, and the lateral talo-first metatarsal angle, which evaluated hindfoot, midfoot, and forefoot alignment. RESULTS: Twenty patients (13 women and 7 men) with a mean age (and standard deviation) of 38.5 {plus minus} 12.3 years were included in the study. The patients had a mean height of 168.1 {plus minus} 7.1 cm, a mean weight of 77.2 {plus minus} 10.5 kg, and a mean BMI of 27.4 {plus minus} 4.3 kg/m2. There was no significant difference between type 1 and type 2 in all radiological parameters. There was no significant correlation between radiological parameters and age, BMI, or the presence of symptoms. CONCLUSIONS: We found that the type of ANB had no effect on the radiological measurements of the foot in which we evaluate the parameters patients with bilateral ANB of different types. Additionally, age, BMI, and the presence of symptoms, also demonstrated no correlation with the radiological parameters of the foot.

A Rare Case of Aneurysmal Bone Cyst – Navicular Bone Treated by Intralesional Sclerotherapy Agent Polidocanol

Introduction: Aneurysmal bone cyst (ABC) is an intraosseous arteriovenous malformation, usually treated by surgical excision but with higher recurrence rates. The occurrence of this lesion in navicular bone is a rare entity. Repetitive sclerotherapy using 3% polidocanol is a minimally invasive, safer method of treatment for ABCs. Methods: A patient of ABC of the navicular bone precisely diagnosed through X-ray, MRI, and biopsy was given periodic injections of 4 ml of 3% polidocanol under aseptic precautions from April 2018 to July 2018. A total of four injections given at an interval of 1 month. Results: Regular follow-up done for 1 year. At the end of all the four injections, the lesion healed completely with a relief in presenting symptoms. No complications were reported. At 3 months post-therapy, the patient was able to walk without pain. After 1 year of follow-up, the patient was symptom-free with no signs of recurrence. Conclusion: Surgical resection/curettage has higher chances of recurrence; therefore, usage of intralesional sclerotherapy agent polidocanol should be considered the treatment of choice in the lesions smaller than 5 cm. Keywords: Aneurysmal bone cyst, sclerotherapy, polidocanol.

Use of Hausdorff Distance and Computer Modelling to Evaluate Virtual Surgical Plans with Three-Dimensional Printed Guides against Freehand Techniques for Navicular Bone Repair in Equine Orthopaedics

Objective The aim of this study was to evaluate the surgical execution of a virtual surgical plan (VSP) with three-dimensional (3D) guides against a freehand approach in the equine navicular bone using an automated in silico computer analysis technique. Study Design Eight pairs of cadaveric forelimb specimens of adult horses were used in an ex vivo experimental study design with in silico modelling. Limbs received either a 3.5 mm cortical screw according to a VSP or using an aiming device. Using computed tomography and computer segmentation, a comparison was made between the executed screw and the planned screw using the Hausdorff distance (HD). Results Navicular bone mean HD registration error was –0.06 ± 0.29 mm. The VSP with 3D printing demonstrated significantly superior accuracy with a mean deviation of 1.19 ± 0.42 mm compared with aiming device group (3.53 ± 1.24 mm, p = 0.0018). The VSP group was 5.0 times more likely to result in a mean aberration of less than 1.0 mm (95% confidence interval, 0.62–33.4). A 3.5 mm screw with an optimal entry point can have a maximum deviation angle of 3.23 ± 0.07, 2.70 ± 0.06 and 2.37 ± 0.10 degrees in a proximal, dorsal and palmar direction respectively, prior to violating one of the cortical surfaces. Conclusion Procedures performed using the 3D guides have a high degree of accuracy, with minimal mean deviations (<1 mm and <1 degree) of a VSP compared with those using the conventional aiming device. The use of VSP and the HD for evaluation of orthopaedic surgeries and outcome measures shows promise for simplifying and improving surgical accuracy.